Amount of naloxone used to reverse opioid overdoses outside of medical practice in a city with increasing illicitly manufactured fentanyl in illicit drug supply
Amount of naloxone used to reverse opioid overdoses outside of medical practice in a city with increasing illicitly manufactured fentanyl in illicit drug supply
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DOI：
10.1080/08897077.2018.1449053
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发表时间：
2019-01-02
期刊：
影响因子：
3.5
通讯作者：
Williams, Leslie D.
中科院分区：
文献类型：
--
作者：
Bell, Alice;Bennett, Alex S.;Williams, Leslie D.
背景：非法制造的芬太尼（IMF）流行率有所增加。然而，在IMF增加的背景下，非医疗旁观者用于逆转阿片类药物过量的纳洛酮剂量存在不确定性。研究方法：我们使用了来自阿勒格尼县医学检查员的关于纳洛酮剂量和致命阿片类药物过量的社区纳洛酮分配计划数据。从2013年1月到2016年12月，工作人员采访了接受纳洛酮治疗的参与者，以应对1072次过量用药。我们计算了频率、百分比，并进行了单因素方差分析（ANOVA）。结果如下：尽管芬太尼导致的死亡增加，但在参与者用于逆转过量的纳洛酮剂量的平均数量方面，4年（2013-2016）中的任何一年（F = 0.88; P = .449）都没有统计学显著差异。总结：尽管IMF比海洛因更有效，并且是阿勒格尼县药物过量死亡的一个迅速增加的因素，但纳洛酮的平均剂量并没有改变。我们的研究结果与不同领域的研究不同，这些研究也经历了越来越多的IMF流行。需要进行更多的调查，以澄清逆转社区中由新合成阿片类药物引起的阿片类药物过量所需的纳洛酮量。
Background: Illicitly manufactured fentanyl (IMF) prevalence has increased. However, there is uncertainty about naloxone dose(s) used by nonmedical bystanders to reverse opioid overdoses in the context of increasing IMF. Methods: We used community naloxone distribution program data about naloxone doses and fatal opioid overdoses from the Allegheny County Medical Examiner. From January 2013 to December 2016, staff interviewed participants who administered naloxone in response to 1072 overdoses. We calculated frequencies, percentages, and conducted a 1-way analysis of variance (ANOVA). Results: Despite increases in fentanyl-contributed deaths, there were no statistically significant differences between any of the 4 years (2013-2016) on average number of naloxone doses used by participants to reverse an overdose (F = 0.88; P = .449). Conclusion: Even though IMF is more potent than heroin and is a rapidly increasing contributor to drug overdose deaths in Allegheny County, the average dose of naloxone administered has not changed. Our findings differ from studies in different areas also experiencing increasing IMF prevalence. Additional investigations are needed to clarify the amount of naloxone needed to reverse opioid overdoses in the community caused by new synthetic opioids.